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Pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction for benign pancreatic diseases

机译:胰空肠造口,肝空肠造口和双Roux-en-Y消化道重建治疗良性胰腺疾病

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摘要

Surgery such as digestive tract reconstruction is usually required for pancreatic trauma and severe pancreatitis as well as malignant pancreatic lesions. The most common digestive tract reconstruction techniques (e.g., Child's type reconstruction) for neoplastic diseases of the pancreatic head often encompass pancreaticojejunostomy, choledochojejunostomy and then gastrojejunostomy with pancreaticoduodenectomy, whereas these techniques may not be applicable in benign pancreatic diseases due to an integrated stomach and duodenum in these patients. In benign pancreatic diseases, the aforementioned reconstruction will not only increase the distance between the pancreaticojejunostomy and choledochojejunostomy, but also the risks of traction, twisting and angularity of the jejunal loop. In addition, postoperative complications such as mixed fistula are refractory and life-threatening after common reconstruction procedures. We here introduce a novel pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction in two cases of benign pancreatic disease, thus decreasing not only the distance between the pancreaticojejunostomy and choledochojejunostomy, but also the possibility of postoperative complications compared to common reconstruction methods. Postoperatively, the recovery of these patients was uneventful and complications such as bile leakage, pancreatic leakage and digestive tract obstruction were not observed during the follow-up period. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
机译:胰腺创伤和严重的胰腺炎以及恶性胰腺病变通常需要诸如消化道重建之类的手术。对于胰头瘤性疾病,最常见的消化道重建技术(例如,Child型重建)通常包括胰空肠造口术,胆总管空肠造口术和胃十二指肠造口术联合胰十二指肠切除术,而由于胃和十二指肠的整合,这些技术可能不适用于良性胰腺疾病在这些患者中。在良性胰腺疾病中,上述重建不仅会增加胰空肠吻合术与胆总管空肠吻合术之间的距离,而且还会增加空肠环牵拉,扭曲和成角度的风险。此外,术后常见并发症如混合瘘管难治,并危及生命。我们在两种良性胰腺疾病中介绍了一种新型的胰空肠吻合术,肝空肠吻合术和双重Roux-en-Y消化道重建术,因此,与常规重建方法相比,不仅减少了胰空肠吻合术与胆总管空肠吻合术之间的距离,而且还减少了术后并发症的可能性。术后患者恢复良好,随访期间未观察到胆漏,胰漏和消化道阻塞等并发症。 (C)2014百事登出版集团有限公司。保留所有权利。

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